Over the past twenty years there have been major advances in medical science. Better techniques and technical equipment have allowed physicians to provide better care and prolong human life as well as improve the standard of that life. Currently, 12.5% of the population of the United States is 65 years of age or older and by 2010 this figure is expected to reach a total of 20% of the population [1]. One of the tools that physicians have available to them to accomplish this task is an expanded array of potent medications. The FDA has approved an average of 340 new medications per for the past several years. According to Emergency Medicine Reports some 90% of people older than 65 years of age take one or more medications per day [1]. The average number of medications by each patient over the age of 60 years in the American Geriatrics Society study was greater than five per day [2].
For maximum effectiveness of these medications to occur, the medications must be taken properly. And while medical science has leaped ahead in many areas one of the problem areas that remain is that of ensuring patient compliance with taking medications.
Compliance is the consistency and accuracy with which a patient follows the regimen prescribed by a physician or other health professional. Compliance is important to insure improved medical care and lower medical costs. The Nursing Standard states that non-Adherence to mediation regimens is a significant problem in older patients, which can lead to therapeutic failure and wastage of medical resources [3]. Gandi found that outpatient drug complications in the ambulatory setting were common, and that this caused an increased use of the medical system which in turn leads to increased cost [4, 5]. Compliance issues are not limited to a specific social economic, educational or cultural level; but affect all cultures [1, 5, 6, 7, 8].
The medical literature indicates that common causes of non-compliance include poor patient memory, physical difficulties, unpleasant side effects of medications, lack of social support, poor and lower education levels, depression, communication problems, medication supply and multiple medications [3, 7, 8, 9, 10, 11]. Several studies show that patients can over utilize or under utilized medications [9, 11, 12]. Golden says that over utilization not only increases medical costs by the patient taking additional medication doses but also increases the risk of adverse drug reactions, for which older patients have an increased risk for [2]. Emergency Medicine Reports estimated that the adverse medication rate for those above the age of 45 is double that of the younger age group [1]. Emergency Medicine Reports have also shown that the medications that older patients are more likely to require, anticoagulants, Antihypertensives, anticonvulsants, digoxin, and anti-inflammatory medications are the medications that are involved in most adverse dosing occurrences [13].
Various methods have been applied to increase patient compliance including verbal and written instructions, home visits, telephone prompting, behavior modification, limited medication access and pill bottle alarms [7, 14, 15]. The International Journal of STD and AIDS states that these methods have met with various degrees of success but to date pill bottle alarms have been the most effective when single medications are involved [6].
Thus, it is evident that a medication delivery system that was able to be accessed easily by the patient, would deliver the right medication at the right time and thus prevent over utilization as well as under utilization would improve medication compliance with increased patient safety by decreasing medication dosage errors and optimize medication utilization would also decrease medical system costs and patient satisfaction. This next level in outpatient medical care can be met by the development of a device that could notify the patient of the appropriate dose of medication at the appropriate time in a manner that the patient with impaired motor ability could access and handle multiple medications. Emergency access would also need to be available. A device that would have these functions would solve many of the compliance issues that have yet to be resolved by other methods.
Elderly and sick people have to take medication due to their ailments or illnesses. Typically, they are prescribed several different types of medication, which must be taken in varying dosages. 25% of the elderly population use four or more prescriptions on a daily basis [16]. Patients must keep track of the correct times in which they are supposed to take these medications. 55% of the elderly fail to comply with medication regiments [16], and 50% of all prescriptions filled are taken incorrectly [17]. Oftentimes, age and sickness take their toll on a person's senses, and it is a common occurrence for individuals on medication to suffer from forgetfulness, lack of concentration, and impaired hearing or sight. Studies show that 43% of the general population make errors in taking medication, 58% of the elderly make errors in taking medication, and of these errors 26% are potentially serious according to their doctors [16]. Unfortunately elderly persons whom live alone often have no one to rely upon but themselves. Keeping track of medication is a very burdensome and often dangerous task for these individuals. There is no reason in this day and age of technology that a device cannot be designed to aid in this important task. Our project will solve the prescription medication compliance problem, which is prevalent among the sick and elderly.
Elderly and sick people suffer from the following problems with taking medication:                Forgetting to take their medication at the proper times.        Taking the incorrect amount of medication at the proper time.        Overdosing their medication by taking it more than once because they forget that it has already been consumed.        Not taking medication on purpose because they are uncertain if they have already taken it.        Remembering which medication is the correct one to take at the proper time.        Attempting to open prescription bottles is difficult due to childproof caps or any hand crippling disease such as arthritis.        
Having a loved one go through these difficulties with medication is a taxing experience for family members. Generally, family members are involved in overseeing and aiding a person with his or her medication. 80% to 90% of people requiring care in the US receive it from family members or friends [17]. This care process can be a very time consuming, frustrating, and stressful period for both family members directly and indirectly involved. It is very hard for family members to come into a situation that is alien to them and try to be responsible for a person that may or may not be able to completely communicate all that needs to be done. Having a system that will take care of these problems associated with medication will not only help the patient but also give the family peace of mind.
This SmartPillBox has been designed using knowledge from several fields. These are                Computer Science/Information Technology        Communication Technology (Interactive voice response, wireless communication, mobile communication, plain old telephony, internet)        Medical Sciences        Microelectronic device design        
4.1 The Smart Pill Box as a Solution to the Medical Non-Compliance Problem
The invention is part of the solution addressing to the medical non-compliance problem. The medical non-compliance problem is known to be a very important one in the medical field. Patients that are not complying with the medical treatment they have been prescribed are said to be non-compliant.
For many patients it is difficult to remember to take medication prescribed to them. Even if the patients remember to take their medication they often forget whether they took it and may take an extra dose of the medication. Many diseases worsen severely if the patient deviates from the prescribed treatment. The problem of non-compliance is known in the medical field to be a very important one. For serious diseases like diabetes and hypertension it can affect the health of the patient in a severely negative way if the patient is not complying with the treatment. A solution to the patient non-compliance problem benefits millions of patients in the USA.
The SmartPillBox offers an effective solution to the patient non-compliance problem. The functionality of the SmartPillBox will be explained in the next section.